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A humanitarian tragedy (plus or minus two million)

23Jan2008

D.R. Congo’s war has killed roughly 5.4 million people due to death and disease, according to a report released by International Rescue Committee on Tuesday. But should we care about this number? Or maybe a better way to ask this question: is this the kind of research that humanitarian agencies should be doing?

According to IRC’s survey, there are an estimated 45 000 excess deaths per month, almost all due to hunger and disease—a rate of death that has not declined since combat activities began to subside several years ago. Death tolls are in fact higher in areas of central DRC, which has not seen war for several years. This is clearly an issue we should care about.

I’d discuss some of the problems with IRC’s figures, but to my surprise the New York Times devoted half an article to unpacking their statistical credibility. Turns out that the 5.4 million number is correct–plus or minus two million.

I love the Times, but it does not usually get high marks for (1) statistical sensibility or (2) nuanced coverage of African events. The credit goes to reporter Lydia Polgreen, who offers some of the consistently best African reporting by a Westerner.

Does it matter if the number is off by two million or more? Maybe not. The best use of such data, I imagine, is to prompt the New York Times (and maybe even lowly academic bloggers) to write an article on the subject–something that just might put the crisis on the agenda in the G8 or the UN security council (that would be the Times, not me). The IRC team interviewed 14,000 households across 700 remote locations. I’m going to hazard a wild guess and say that the research effort probably cost $350,000. Not a bad deal for coverage in several of the world’s leading newspapers.

Even so, I can imagine research that produces the same advocacy impact but has much more operational use. By which I mean any operational use. One of the researchers is quoted saying that, “These data can help us understand the scale of the problem and target our solutions to save lives.” This statement sounds much less impressive if you add “plus or minus two million people” to the end. No humanitarian program manager I know bases decisions on such data.

Wouldn‘t it be better if the survey and research design were more attuned to measuring the determinants of mortality than the levels? The influence of government programs? The effectiveness of alternative interventions? The relationship between mortality and local health care, or the difference when doctors and nurses show up to work?

A national mortality rate could easily be a byproduct of such an effort. It would be more poorly measured, of course, but nobody except me (and Lydia Polgreen!) is probably going to notice.

P.S. For everyone out there who is infuriated at this post, don’t worry. I’m having dinner with IRC’s research director, a close friend, on Friday night and she’ll let me have it.

P.P.S. I should also mention that IRC and others are already doing the kind of research I suggest, even in eastern DRC. The trick is to think more critically and creatively about the standard epidemiological surveys that are still a major focus of many humanitarian disasters.

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Seems you and I have interests in common–I truly enjoyed reading your blog. Let me know if you’re interested in participating in the 2008 HMF International Film/Media Festival & Conference (NYC, December 10-14, 2008), which is the first major initiative of the Humanitarian Media Foundation (HMF). Panels are to be formed over the coming months on issues of humanitarian importance to occur in conjunction with the screenings.

“Wouldn’t it be better if the survey and research design were more attuned to measuring the determinants of mortality than the levels? The influence of government programs? The effectiveness of alternative interventions? The relationship between mortality and local health care, or the difference when doctors and nurses show up to work?”

In the absence of that work, I’ll take the data on levels, even if it is plus or minus two million.

The work you’re asking for is difficult to get, and would cost roughly the same (or more?) in the DRC, as you already know. The question to ask your friend over dinner tomorrow night is if the IRC would have funded such research. Is it in their interest to do so? Does IRC get more bang for its buck by conducting research on levels rather than mechanisms? What motivates the IRC to do research about mortality?

Could someone else have done the research you’re asking for? Likely a political scientist/economist type could do it — who would fund that research? In the time it would take to write a convincing NSF proposal or letter of interest to a foundation, how does the situation change — and more importantly, how would any change in the situation impact the research previously designed?

The Security Council has chosen to address this issue because it is time for Peace.It is time for action not with guns and landmines, but with words, demands, and the worldÃ¢â‚¬â„¢s insistence that war stop, so that peace and people can thrive.

I’m an Associate Professor of Political Science & International and Public Affairs at Columbia University. I use field work and statistics to study poverty, political engagement, the causes and consequences of violence, and policy in developing countries. [Read more]